Should seniors be taking low-dose aspirin for primary prevention of heart attacks?

Spectrum Health cardiologist offers opinion

GRAND RAPIDS, Mich., Sept. 17, 2018 – A new research study questions the effectiveness of daily low-dose aspirin for the primary prevention of heart attacks and strokes and has patients reaching out to cardiologists for direction.

The joint Australian-U.S. study of greater than 19,000 healthy older patients was recently published online by the New England Journal of Medicine and was also presented at the European Respiratory Society International Congress in Paris, France.

David Wohns, MD, MBA, FACC, division chief, cardiovascular medicine at Spectrum Health’s Meijer Heart Center offers analysis and advice for patients.

“This aligns with other recent negative studies of aspirin in primary prevention,” said Dr. Wohns. “This is a major study of more than 19,000 people over the age of 70 (or over 65 in the U.S. if black or Hispanic, due to their higher risk) who showed no benefit from taking aspirin in primary prevention and some of whom may have been harmed. Specifically, these are seniors with no vascular disease where no benefit is shown in extending disability-free survival and there is no significant reduction in cardiovascular disease. In addition, there is a small but significant increased risk for major hemorrhage and small but higher all-cause mortality in these individuals, possibly due to increased cancer risk.”

The study, intended for a five-year follow up, was stopped at 4.7 years due to the negative results.

“Because there appears to be no benefit of aspirin in this older healthy population to prevent first cardiovascular events, we are strongly encouraging people in this age group who are on aspirin and are wondering about stopping it to check first with their doctor.” added Dr. Wohns.

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